Cochlear implantation in the over 85s
Reviewed by Kerri Millward & Morag Lockley

An ageing population globally, means that the individuals of some countries are now living longer and, as hearing loss is commonly associated with the elderly, there will be more elderly people eligible for cochlear implantation. Hearing loss itself is associated with other health concerns in the elderly, including dementia, depression, social isolation and lower quality of life. Therefore, it is important that hearing loss is treated promptly in this cohort. However, many eligible patients over 85 years may not go ahead with the procedure due to concerns about adapting to the new sounds (i.e. plasticity of the brain) and the surgery itself, especially if other comorbidities exist. A study looking at the effectiveness of cochlear implantation within this population showed that many had comorbidities, with hypertension and heart disease being the most common. However, by considering the option of other anaesthetic approaches in this group, such as local anaesthetic, surgical complication can be minimised. Indeed, this study found that less than 5% had complications due to surgery, and most resolved after a few days. Outcomes for this group were promising, with improvements being found in all areas post op. Monosyllabic words improved by 37%, sentences in quiet by 45% and sentences in noise by 28%. These improvements were seen as early as three months post op and remained when tested at three years post implantation. However, some of the improvements seen post implant are not as great as those seen in the younger implanted adult population. Nevertheless, cochlear implantation has been shown to be an effective, safe and beneficial intervention for those aged 85 years and over with severe to profound hearing loss.

Outcomes of cochlear implantation in adults over 85 years of age.
Spitzer ER, Waltzman SB.
COCHLEAR IMPLANTS INT
2021;22(5):296-302.